目的 了解2011年四川大学华西第二医院临床分离菌对常见抗菌药物的耐药性。 方法 采用法国生物梅里埃公司VITEK 2 COMPACT全自动细菌鉴定药敏仪，以及ATB 手工药敏条检测临床分离菌对各种常用抗菌药物的耐药性，参照CLSI 2011年版标准判定药敏试验结果，并用WHONET5.4软件统计分析。 结果 临床分离的1 692株细菌中，G+菌占28.0%（473/1 692），G?菌占72.0%（1 219/1 692）。分离的前5位病原菌分别为大肠埃希菌、流感嗜血杆菌、肺炎克雷伯菌、肺炎链球菌、金黄色葡萄球菌。耐甲氧西林金黄色葡萄球菌和耐甲氧西林的凝固酶阴性葡萄球菌分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的15.1%（22/146）和76.7%（46/60），未检出万古霉素、利奈唑胺耐药株。屎肠球菌对所测抗菌药物的耐药性显著高于粪肠球菌，对氨苄西林的耐药率分别为95.7%和13.3%，高水平氨基糖苷类抗生素耐药屎肠球菌和粪肠球菌的耐药率分别为82.6%和30.0%，检出1株对万古霉素耐药的屎肠球菌，未发现对利奈唑胺耐药菌株。青霉素耐药的肺炎链球菌占4.0%（6/151），肺炎链球菌对红霉素、克林霉素、四环素、复方磺胺的耐药率均高于90%。流感嗜血杆菌、副流感嗜血杆菌以及卡他布兰汉菌产β内酰胺酶的比例分别为58.1%（175/301）、70.0%（21/30）、75.9%（22/29）。肠杆菌细菌中产超广谱β内酰胺酶的大肠埃希菌和肺炎克雷伯菌检出率分别为59.9%和74.1%，耐药率最低的分别是3种碳青酶烯类抗生素和阿米卡星。不发酵糖G?杆菌在分离病原菌中所占比例较低，为12.1%（148/1 692），主要为鲍曼不动杆菌和铜绿假单胞，药敏结果显示，除铜绿假单胞对复方磺胺耐药率为93.5%和鲍曼不动杆菌对氨曲南耐药率为38.9%外，该两种细菌对所测抗生素敏感性高，均在80%以上，未检出泛耐药细菌。 结论 定期进行细菌耐药性监测有助于了解医院细菌耐药性变迁，对指导医院合理应用抗菌药物有重要意义。
目的 分析下肢慢性创伤性骨髓炎患者创面细菌培养分布情况，为临床用药提供依据。 方法 对2006年1月－2010年12月收治的91例慢性骨髓炎患者创面分泌物细菌培养标本结果进行回顾性调查分析。其中男78例，女13例；年龄5～78岁，平均41.3岁。病程47 d～7个月，平均68.6 d。使用抗生素总疗程均＞7 d。 结果 65例创面细菌培养阳性患者共分离出113株病原菌，其中G?菌72株，占63.71%；G+菌41株，占36.28%。药敏结果显示，G+菌对常规青霉素类基本耐药，碳青霉烯类耐药菌株少见，对万古霉素耐药菌株尚未出现。G?菌对青霉素类及头孢菌素类耐药较高，对头孢哌酮－舒巴坦无耐药。 结论 加强对慢性创伤性骨髓炎患者创面病原菌监测极为必要,对临床抗生素的合理使用具有一定的指导意义。Objective To analyze the distribution of cultured bacteria from chronic osteomyelitis patients, and provide a basis for clinical medicine. Methods We retrospectively analyzed the bacterial culture results of the secretions from 91 patients with chronic osteomyelitis treated in our hospital from January 2006 to December 2010. Among them, there were 78 males and 13 females aged from 5 to 78 years averaging at (41.3 ± 8.35) years. The duration of the disease ranged from 47 days to more than 7 months, averaging (68.6 ± 14.57) days. The total course of antibiotic-taking was longer than 7 days for all the patients. Results A total of 113 pathogen strains were isolated from 65 secretion samples, including 72 Gram-negative bacteria accounting for 63.71% and 41 gram-positive bacteria accounting for 36.28%. Drug susceptibility results showed basic resistance of Gram-positive bacteria to conventional penicillin, rare resistance to carbapenem, and no resistance to vancomycin. Gram-negative bacteria were basically resistant to penicillin and cephalosporins, but not resistant to cefoperazone-sulbactam. Conclusion Enhancing the monitoring of pathogens for patients with chronic osteomyelitis is extremely necessary for the rational clinical use of antibiotics.
Objective To investigate the antibiotic resistance and their genetic homology of stenotrophomonas maltophilia isolated from January 2005 to February 2006 at intensive care unit（ICU） of 6 hospitals in Bejing area.Methods The minimal inhibitory concentration（MIC） of 12 antibiotics against 82 strenotrophomonas maltophilia was determined by broth dilution method.PFGE was used to analyze the homology of 82 stenotrophomonas maltophilia.Results The drug sensitivity tests in vitro showed these strains were resistance to commonly-used antibiotics.Antibiotics with sensitive rate over 50% included Doxycycline, gatifloxacin,cefoperazone-sulbactam,levofloxacin,Compound sulfamethoxazole,Ceftazidime and ticarcillin- clavulanate. 7-18 DNA bands of different size were present in the gel and different homology was shown among the 82 strains.Four couples with homology over 85% were isolated from the same ICU.Three strain were same clones in PLA General Hospitals first hospital.2 couples from the different wards had homology of 80.6% and 79.6% of，respictively.Others strains had either poor or no homology.Conclusions No clonal outbreak is certified at ICU of 6 hospitals in Beijing area. There are only vertical dissemination of single clone in 6 ICU wards.PFGE is an effective approach for drug resistance test and epidemic analysis.
目的 了解呼吸机相关性肺炎（VAP）患者病原菌情况，探讨其细菌耐药性及治疗策略。 方法 通过查阅2008年1月－2009年12月呼吸与危重症医学科收治的128例VAP患者的病历资料，分析其肺部感染病原菌分布特点及耐药率。 结果 VAP平均发病时间为机械通气后5.8 d，总病死率为35.1%（45/128）。共分离出病原菌262株，其中G?杆菌210株（占80.2%），G+球菌38株（占14.5%），真菌14株（占5.3%）。G?杆菌中占前3位的分别是鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷白杆菌，对青霉素类、头孢菌素类抗菌药物高度耐药，而对亚胺培南等耐药率相对较低；G+球菌主要是金黄色葡萄球菌，其中耐甲氧西林的金黄色葡萄球菌对多种常见抗菌药物高度耐药，而对万古霉素敏感。 结论 VAP的主要病原菌为G?杆菌，常为多重耐药的致病菌，应根据药敏结果选用合理的抗菌药物。
目的 探究艾滋病(AIDS)合并马尔尼菲青霉病(PSM)的感染率，以及常规实验室检查结果和5种抗真菌药物对马尔尼菲青霉菌(PM)的体外抗菌活性。 方法 2006年1月-2009年11月间确诊AIDS患者326例，从其血液、骨髓培养出65株PM，检测该65例患者的血常规、肝功能和肾功能，并对20株酵母相PM进行体外药敏进行分析。 结果 AIDS合并PSM的感染率为19.94%；外周血常规：WBClt;4.0×109/L者48例，HBlt;100 g/L者51例，PLTlt;100×109/L者46例。肝功能检查：ALTgt;40 U/L者49，ASTgt;40 U/L者51例，GGTgt;60 U/L者44例，ALPgt;150 U/L者36例，ALBlt;35 g/L者53例，A/G倒置者50例。肾功能检查：BUNgt;7.2 mmol/L者9例，Crgt;150 μmol/L者4例。20株酵母相PM对5-氟胞嘧啶(5FC)、两性霉素B(AMB)、氟康唑(FCA)、伊曲康唑(ITR)、伏立康唑(VRC)的敏感率分别为75%、90%、80%、90%、90%。 结论 AIDS合并PSM感染率较高；患者感染后外周血WBC、HB、PLT通常低于正常人，肝功能多表现异常，肾功能的改变较少；对PM的治疗以AMB、ITR、VRC为首选。
摘要:目的:了解细菌药物敏感性以指导临床合理选用抗生素。方法:采用VITEK32及GNS120药敏卡、GPS107药敏卡完成细菌的鉴定及药敏实验。结果:葡萄球菌占72.5%。青霉素对葡萄球菌敏感性几乎为0,葡萄球菌的产酶率均在95%以上。结论:临床应了解细菌对抗生素的耐药特点,掌握好适应症,科学合理选用抗生素
目的：为临床合理应用抗生素提供依据。方法：采用VITEK 32及GNS--120药敏卡、GPS -107药敏卡进行细菌的鉴定及药敏实验。结果：320 株病原菌中，革兰氏阳性菌占28.75 %，革兰氏阴性菌占71.25 %，其中大肠埃希菌、铜绿假单胞菌、鲍曼复合醋酸钙不动杆菌、阴沟肠杆菌、金黄色葡萄球菌是临床上主要致病菌。结论：临床应科学合理选用抗生素，尽量减少和延缓耐药菌的发生及发展。
Objective To explore the value of chemosensitivity assay in vitro on breast cancer. Methods In vitro chemosensitivity of 6 species of chemotherapeutic agents applied to 38 cases of breast cancer patients were detected by tissue culture-end point staining-computer image analysis (TECIA). Results The sensitivity to chemotherapeutic agents commonly used in the breast cancer level from high to low was as follow: Doxorubicin (ADM), Paclitaxel (TAX), Vinorelbine (NVB), Cyclophosphamide (CTX), Cisplatin (DDP) and Fluorouracil (FU). Conclusion Drugs sensitivity experiment of cancer in vitro by TECIA has an important value to instruct clinical medication and individual chemotherapy for breast cancer.
Objective To investigate the differences in bacteria distribution and drug resistance of pathogens in patients with lower respiratory tract infection between respiratory general wards and respiratory intensive care unit ( RICU) .Methods All the clinical isolates fromsputumor secretion of lower respiratory tract from2007. 1-2010. 10 were analyzed retrospectively. Antibiotic susceptibility was tested by Kirby-Bauer method. Results The total number of isolated strains was 3202. Among 1254 strains isolated from respiratory general wards, Gram-positive bacteria accounted for 2. 63% , Gram-positive bacteria accounted for 42. 42% , and fungi accounted for 54. 95% . Streptococcus pneumoniae ranked first place among Gram-positive bacteria, accounting for 51. 52% . Haemophilus parainfluenzae bacillus ranked first place among Gramnegative bacteria, accounting for 21. 99% . Both were sensitive to the most commonly used antibiotics. Among 1948 strains isolated from RICU ward, Gram-positive bacteria accounted for 4. 52% , Gram-positive bacteria accounted for 37.73% , and fungi accounted for 57. 75% . Staphylococcus aureus ranked first place among Gram-positive bacteria, accounting for 52. 27% . Acinetobacter baumannii ranked first place in Gramnegative bacteria, accounting for 27. 35% . Both were resistant to most commonly used antibiotics. Pseudomonas aeruginosa had a higher rate of infection both in the general wards and RICU, and was resistant to most commonly used antibiotics.Conclusions In lower respiratory tract infection of respiratory general ward, Gram-positive bacteria with Streptococcus pneumoniae mainly and Gram-negative bacteria with Haemophilus parainfluenzae mainly are both sensitive to the most commonly used antibiotics. While in the RICU ward, Gram-positive bacteria infections with Staphylococcus aureus mainly and Gram-negative bacteria infections with Acinetobacter baumannii mainly are both resistant to most commonly used antibiotics.